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Universalize social security, the challenge for Latin America

We are in an uncertain systemic situation, derived from the expansion, duration, and expectancy provided by the pandemic. The most significant impact in the attempt to reorganize life in a context of a forced economic standstill, as well as of deep social inequalities, demonstrating that, to readjust them, we first need to maintain life and for this we need income.


During the last decades, the emphasis was on favoring market relations, almost above the State and society. Therefore, the incessant search for creating financial gain, made us neglect the course of life itself, exacerbating poverty, precariousness, and vulnerability amid an absence of a base of social protection of universal proportions.


Overcoming this situation and building social security directed at human protection and perhaps combining it with a minimum vital income as a social and universal right, is the first great challenge identified by the Latin American Council of Social Sciences (CLACSO, for its Spanish acronym), which would require ample citizen participation.


The countries of the region have great coincidences in the origin of their social security systems, with a labor orientation –focused only on securing subordinate salaried workers– and fragmented in several systems, having unequal access, and benefits, dividing and polarizing society even more and leading to a series of reforms, ones more radical than others.


Read more: Decree 1174 of 2020: hidden social security and labor reform
 

Social security: public and inclusive


Since the 80s, governments have been implementing diverse social security financing and orientation models that have turned pension systems into savings systems, individualized and privatized, all with poor results. Back in 1991, Chile was the first country to subscribe to a completely privatized model; then came México in 1995, Bolivia and Venezuela in 1997, El Salvador in 1998, and the Dominican Republic in 2013. Among those who adopted mixed, public, and private systems were: Peru in 1993, Colombia and Argentina in 1994, Uruguay in 1996, Costa Rica in 2000, and Panama in 2008. It is worth noting that in some countries, mixed systems are complementing, while in others they compete among themselves. On the other hand, Venezuela turned back to a public system in 2002, Argentina in 2008, and suspended in Ecuador since 2001.


Latin American governments have implemented several reforms, modifying payments and ages –like Cuba and Brazil– but maintaining a public distribution system. Some have created assistance pensions with a fiscal cost for those who are not subscribed or do not obtain a pension, with hardly any results and that deepen inequality. Therefore, overcoming the absence of a solid, universal, inclusive, ample and fiscally sustainable social security is a great challenge.


The predominance of the perspective focused on labor, almost exclusively related to subordinated salaried work, does not allow universal coverage in a market with high rates of informal occupation and precariousness, which the International Labor Organization (ILO) says is close to 53%.


Currently, on average, only 46% of Latin American workers contribute toward a pension. The complexity is when we observe countries such as Uruguay with 75% of its population occupied, in contrast to Brazil, Argentina, or Costa Rica with 50%, or like Mexico, Colombia, and the rest of the Central American countries with less than 37%, as shown by the Economic Commission for Latin America and the Caribbean (ECLAC) in its 2019 Overview on the Latin American Social Scenario.


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The situation has compelled some to establish non-contributory pensions and even others of welfare nature, focused on those who do not contribute or acknowledging the times of care and non-salaried work of women.


Coverage has grown but inequalities are still manifested. 65% of those who belong to the quintile of higher income are protected by public social security, in face of the 19% of the quintile of lesser income.


In the same report, ECLAC says that people older than 65 with the highest income report an average pension of US $ 1,427 a month, while the group of people in extreme poverty report just US $81. Incorporating all types of work into social security (independent, agricultural, merchants, among others) would allow going towards a real formalization given the work situation and improving the conditions for activities established by household economic units, a third identified challenge.
 

Healthcare, at the center of social decisions


In some countries of the region, social security healthcare is separated into specific institutions, as opposed to others, such as in Mexico, where they are all maintained under Social Security.


What is important to highlight is that the pandemic surprised public healthcare: unfunded, commercialized in many care groups, unorganized to face pandemic challenges, and with lack of personnel, for prioritizing surrogacy or service subcontracting.


Also, the pandemic uncovered a Latin American population with a deficient public healthcare system, high diabetes, obesity, and high blood pressure rates, and other morbidities proper of deficient nutrition or neglected health, which need to be urgently reverted.


If we want to change the future, healthcare needs to be at the center of social, political, and economic decisions; for this, it is fundamental to strengthen universal, non-segmented, and non-commercialized healthcare.


Boosting comprehensive and transverse preventive programs linked to good nutrition, physical exercise, and mental health requires strengthening services, public goods, and services; integrating social movements that have called for better healthcare conditions as a social and universal right and promoting communitarian participation in supervising the status of healthcare. And although this fourth great challenge has been left for the end of this analysis, it is one of the most relevant to change and strengthen if we want to face the sanitarian and social threats derived from the pandemic, that of COVID-19, and the ones to come in the future.

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